Chen Tsai-Ling, Chang Shu-Chen, Hsieh Hsiu-Fen, Huang Chin-Yi, Chuang Jui-Hsiang, Wang Hsiu-Hung
College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan.
J Psychosom Res. 2020 Aug;135:110144. doi: 10.1016/j.jpsychores.2020.110144. Epub 2020 May 21.
Mindfulness-based stress reduction (MBSR) is a potentially effective supplement for the treatment of insomnia; however, there is no comprehensive review of its mental health effects among insomnia patients. This study aimed to synthesize relevant quantitative evidence and evaluate MBSR application and effectiveness for insomnia patients' sleep quality and mental health.
A systematic search through eight databases from the earliest available dates until August 2019 was conducted. Randomized controlled trials assessing the effects of MBSR on sleep quality, anxiety, and depression as outcome measures among insomnia patients comprising patients aged above 18 years were included in this meta-analysis. Each study's quality was assessed using the modified Jadad quality scale. The Review Manager 5.3 software was used to calculate the standardized mean differences (SMD) with 95% confidence intervals (CIs) for the data analyses.
In total, data for 497 patients in seven randomized controlled trials were analyzed. The results revealed that compared to the control group, the MBSR group significantly improved in sleep quality (SMD = -0.69, 95% CI: -1.12~ - 0.26, Z = 3.16, p = .002), depression (SMD = -1.83, 95% CI: -2.81-0.84, Z = 3.63, p < .001), and anxiety (SMD = -1.74, 95% CI: -2.90-0.59, Z = 2.96, p = .003). A sensitivity analysis was undertaken. After carefully reviewing included trials, we can reasonably conclude that these heterogeneities did not impair the overall effect size of MBSR in the results.
MBSR significantly improved sleep quality and mental health. Future research is needed using standardized methods examining the long-term effects of MBSR on the mental health of individuals with insomnia.
基于正念的减压疗法（MBSR）可能是治疗失眠的一种有效补充方法；然而，目前尚无关于其对失眠患者心理健康影响的全面综述。本研究旨在综合相关定量证据，评估MBSR对失眠患者睡眠质量和心理健康的应用效果。
从最早可获取的数据至2019年8月，通过八个数据库进行系统检索。本荟萃分析纳入了评估MBSR对失眠患者睡眠质量、焦虑和抑郁影响的随机对照试验，这些患者年龄在18岁以上，以这些作为结局指标。使用改良的Jadad质量量表评估每项研究的质量。采用Review Manager 5.3软件计算标准化均数差（SMD）及95%置信区间（CI）用于数据分析。
共分析了七项随机对照试验中497例患者的数据。结果显示，与对照组相比，MBSR组在睡眠质量（SMD = -0.69，95% CI：-1.12~ -0.26，Z = 3.16，p = .002）、抑郁（SMD = -1.83，95% CI：-2.81 - 0.84，Z = 3.63，p < .001）和焦虑（SMD = -1.74，95% CI：-2.90 - 0.59，Z = 2.96，p = .003）方面均有显著改善。进行了敏感性分析。在仔细审查纳入的试验后，我们可以合理地得出结论，这些异质性并未损害MBSR在结果中的总体效应大小。
MBSR显著改善了睡眠质量和心理健康。未来需要采用标准化方法进行研究，以检验MBSR对失眠个体心理健康的长期影响。
